What is a Hernia?

A hernia typically results from a combination of muscle weakness and strain. It is a common condition that causes a localized bulge in the abdomen or groin.

Treatment options for a hernia may include “watchful waiting” or surgery, depending on the severity and any complications.

Fast Facts on Hernias:

• Hernias are usually diagnosed by physically feeling and observing the bulge.
• Treatment can involve either “watchful waiting” or corrective surgery (open or keyhole).
• Inguinal hernia surgery is most common in childhood and old age, while femoral hernia surgery is less common.
• Hernias may not always cause troubling symptoms, but abdominal complaints could signal a serious issue.

Causes:

Some common causes of muscle weakness or strain that can lead to a hernia include:

• Aging
• Injury or surgery-related damage
• Obesity
• Chronic coughing or Chronic Obstructive Pulmonary Disease (COPD)
• Strenuous exercise or lifting heavy weights
• Constipation
• Ascites (fluid buildup in the abdomen)
• Pregnancy (especially multiple pregnancies)

Risk Factors:

• Genetic predisposition
• Older age
• Low birth weight or being born prematurely
• Cystic fibrosis
• Chronic constipation
• Pregnancy
• Obesity
• Smoking
• Chronic cough

Symptoms by Type:

The most common sign of a hernia is a bulge that can be seen or felt under the skin.

1. Femoral Hernia:
   • A bulge in the upper thigh below the groin.
   • Symptoms include sudden pain, nausea, vomiting, and pain in the stomach area.
2. Umbilical Hernia:
   • Most common in babies and children but also occurs in adults.
   • Symptoms include pain near the bellybutton, visible bulge during coughing.
3. Hiatal Hernia:
   • Occurs when part of your stomach moves up into the chest through the diaphragm.
   • Symptoms include chest pain, heartburn, indigestion, trouble swallowing, sore throat, hoarseness, and a lump sensation when swallowing.
4. Incisional Hernia:
   • Happens after surgery when tissue protrudes through weak muscles.
   • Symptoms include fever, fast heartbeat, vomiting, nausea, pain near the bulge, and a bulge near the surgical site.
5. Inguinal Hernia:
   • The most common type, occurring when tissue (often part of the intestine) pushes into the inguinal canal near the groin.
   • Symptoms include pain or discomfort in the groin, especially when bending, coughing, or lifting, and a noticeable bulge.

Diagnosis:

• Physical Exam: A doctor will check for a bulge in areas like the groin, abdomen, or scrotum.
• Abdominal Ultrasound
• Abdominal MRI or CT Scan
• X-rays of the Digestive Tract
• Endoscopy

Treatment:

• Lifestyle adjustments:
  • Stay hydrated
  • Eat high-fiber foods such as whole grains, fruits, and vegetables.
  • Avoid heavy meals or spicy food.
  • Avoid smoking and maintain a healthy weight.
• Surgical Repair: The only effective treatment for a hernia is surgical repair, depending on the size and severity.
• Truss: For some, wearing a supportive undergarment called a truss can help manage symptoms, but make sure it’s fitted properly by a doctor.
• For Hiatal Hernia: Over-the-counter (OTC) or prescription medications (such as antacids, H2 receptor blockers, or proton pump inhibitors) can help reduce stomach acid and relieve discomfort.

Prevention:

• Maintain a healthy weight.
• Consume a fiber-rich diet.
• Avoid straining during bowel movements or urination.
• Exercise regularly.
• Stay hydrated.
• Avoid heavy lifting.
• Refrain from smoking.
• Prevent constipation.

Complications:

Hernias can lead to serious complications, including:

• Inability to pass gas or have bowel movements
• Vomiting or nausea
• Fever
• Sudden worsening pain
• Bowel perforation or obstruction
• Infection
• Hernia recurrence
• A burning feeling near the hernia
• Urinary retention